Iron status of schoolchildren (6–15 years) and associated factors in rural Nigeria

Abstract

BackgroundSchoolchildren are vulnerable to anaemia because of their higher iron need to meet the demands of puberty and adolescence.ObjectiveThe survey determined the haemoglobin levels of schoolchildren aged 6–15 years and the factors affecting their haemoglobin status.DesignData were obtained through a cross sectional survey of 450 randomly selected schoolchildren in Ede-Oballa, Nsukka, Enugu State, Nigeria. Ninety were selected for clinical examination, biochemical tests, and nutrient intake study. Haemoglobin, malaria, and stool analysis were carried out by the cyanmethaemoglobin, thin blood film, and wet mount direct methods, respectively. Iron intake was determined by a three-day weighed food intake.ResultsResults showed that the schoolchildren had pallor (35.6%), brittle hair (31.1%), koilonychia (2.2%), oedema (4.4%) and sore/smooth tongue (7.8%). The children also had malaria (58.9%) and Entamoeba histolytica (42.2%), hookworm (36.7%), tapeworm (35.6%), whipworm (34.5%), and roundworm (27.9%) infestations. Iron intake was inadequate (<100% of recommended nutrient intake) for most of the children. The mean haemoglobin levels of the schoolchildren were low. The 6–9, 10–12, and 13–15 year olds had 9.0, 9.1, and 9.3 g/dl, respectively. Most (85.5%) of them had anaemia. Moderate anaemia was prevalent in 62.2%. Severe anaemia affected the 6–9 year olds more. Malaria (P<0.001), Entamoeba histolytica (P<0.01), hookworm (P<0.05), tapeworm (P<0.01), and whipworm (P<0.001) caused significant reduction in haemoglobin level. Age (b=1.284, P<0.05), birth order (b=−0.629, P<0.01), frequency of illness attack (b=−1.372, P<0.01), household size (b=−0.526, P<0.05), and frequency of skipping breakfast (b=−1.542, P<0.001) were factors that influenced the haemoglobin status of the children.ConclusionThe schoolchildren had poor iron status as a result of consumption of plant sources of iron with low bioavailability, parasitic infections, birth order, skipping of breakfast, large household size, and frequent bouts of illnesses.

Socio‐cultural and economic determinants and consequences of adolescent undernutrition and micronutrient deficiencies in LLMICs: a systematic narrative review

“…Moreover, some studies show that the poorer nutritional status of later born children might be due to already depleted maternal stores caused by multiple pregnancies . However, except three studies, we did not find much evidence on the associations between birth order and adolescent nutritional status. It may be that, over time, its effect is diluted.…”

“…Among Bangladeshi adolescent girls and boys, age was positively associated with serum retinol as well as Hb status. Except in one study on Hb status from Nigeria, birth order was seemingly not an important determinant of poor micronutrient status …”

“…Overall, a larger family size was a risk factor for anemia, 97 and inversely associated with serum retinol and vitamin C status 103 besides serum ferritin, 126 Hb, 115 and folate status. 120 Bangladeshi adolescents living in their parent's houses, 127 as well as Indian adolescents living in a household with electricity, 119 were found to have a higher Hb status.…”

“…Except in one study on Hb status from Nigeria, birth order was seemingly not an important determinant of poor micronutrient status. 115 Only four studies examined the effect of working status or workload on micronutrient status, with two of the studies concluding that working girls had a higher risk of anemia and iron and zinc deficiency, compared with their nonworking peers. 43,116 Similarly, only a few (n = 5) of the reviewed studies examined the effect of marital status on micronutrient status, and this was generally on anemia.…”

Pengaruh infeksi hookworm terhadap kadar hemoglobin penambang intan

“…Jumlah sampel feses yang berhasil dikumpulkan sebanyak 129 dari penambang intan dengan hasil pemeriksaan ditemukan 6 orang positif terinfeksi Hookworm (SPR 4,65%). 6 Dilaporkan bahwa infeksi Hookworm adalah penyebab umum dari anemia di Nigeria, 23 sebanyak 29% infeksi Hookworm dengan anemia ditemukan di Sub Saharan Afrika. 24 Hookworm juga dianggap sebagai faktor pencetus anemia sedang dan berat pada anak-anak sekolah di Mozambique.…”